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Interpretation bias in health anxiety: a systematic review and meta-analysis

Published online by Cambridge University Press:  09 November 2022

Xiayu Du Open the ORCID record for Xiayu Du [Opens in a new window] ,
Michael Witthöft Open the ORCID record for Michael Witthöft [Opens in a new window] ,
Tao Zhang Open the ORCID record for Tao Zhang [Opens in a new window] ,
Congrong Shi Open the ORCID record for Congrong Shi [Opens in a new window]  and
Zhihong Ren Open the ORCID record for Zhihong Ren [Opens in a new window]
Xiayu Du
Affiliation:
Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
Michael Witthöft
Affiliation:
Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
Tao Zhang
Affiliation:
Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
Congrong Shi
Affiliation:
Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
Zhihong Ren*
Affiliation:
Key Laboratory of Adolescent Cyberpsychology and Behavior (Ministry of Education), Key Laboratory of Human Development and Mental Health of Hubei Province, National Intelligent Society Governance Experiment Base (Education), School of Psychology, Central China Normal University, Wuhan, China
*
Author for correspondence: Zhihong Ren, E-mail: ren@ccnu.edu.cn
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Abstract

Interpretation bias (i.e. the selective negative interpretation of ambiguous stimuli) may contribute to the development and maintenance of health anxiety. However, the strength of the empirical evidence for this association remains a topic of debate. This study aimed to estimate the association between health anxiety and interpretation bias and to identify potential moderators of this association. Chinese-language databases (CNKI, VIP, and Wanfang), English-language databases (Web of Science, PubMed, PsycINFO, and Scopus), and German-language databases (Psyndex and PubPsych) were searched for relevant studies. There were 36 articles (39 studies) identified by this search (N = 8984), of which 32 articles (34 studies) were included in the meta-analysis (N = 8602). Results revealed a medium overall effect size (g = 0.67). Statistically equivalent effect sizes were observed for patients diagnosed with clinical health anxiety (g = 0.58) and subclinical health anxiety (g = 0.72). The effect sizes for threat stimuli that were health related (g = 0.68) and not health related (g = 0.63) did not differ significantly. The effect size for studies using an offline paradigm (g = 0.75) was significantly higher than that for studies using an online paradigm (g = 0.50). It is concluded that health anxiety is significantly and robustly associated with interpretation bias. These findings are of central importance for the advancement of models and treatment of health anxiety.

Keywords

COVID-19health anxietyinterpretation biasmeta-analysis
Type
Review Article
Information
Psychological Medicine , Volume 53 , Issue 1 , January 2023 , pp. 34 - 45
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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Footnotes

‡

This article has been updated since its original publication. A notice detailing the updates can be found here: https://doi.org/10.1017/S003329172300017X

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